Expanding non-directed kidney donation: the Renewal model

"Although 90% of Renewal’s donors are ultra-Orthodox, about half their recipients are people like Sarna, who come from the broader Jewish community.

"The average wait time for a kidney through Renewal is six to nine months.

"Because many ultra-Orthodox rabbis believe that organ donation from dead bodies is against Jewish law, Renewal focuses solely on live donors. That puts Renewal’s donors in an extremely rare group of several hundred Americans who, each year, donate their kidney altruistically to a stranger...."Researchers are studying Renewal’s model to see whether it can be replicated in other race- and faith-based communities. Meanwhile, one African-American transplant surgeon is setting up a group modeled on Renewal in a prominent Harlem church.

"Anthony Watkins, an assistant professor of surgery at Weill Cornell Medical College, has witnessed Renewal’s work firsthand, ever since he began his transplant fellowship six years ago. “I’ve always thought that what Renewal does is spectacular and fantastic and [that] maybe this could be duplicated in other communities,” he said.

"Watkins thinks that by using Renewal’s model — appealing to African Americans to help fellow African Americans — he can persuade people to donate in greater numbers. “I think once you establish a good rapport and knowledge and education… you can get altruistic donors to step forward,” Watkins said. But how many people are willing to donate a live organ to a stranger?..."Renewal facilitates an average of about 50 kidney transplants a year. About three-quarters of those transplants are ultra-Orthodox donors giving to a Jewish stranger.

"Ultra-Orthodox Jews account for just 0.2% of America’s population. Yet last year, by the Forward’s estimates, they accounted for up to 17% of the people who donated a kidney to strangers.

"Rees realized that if Renewal’s model of communally focused organ donation could be extrapolated to the general population, it could create tens of thousands of additional kidney donors. The waiting list could be reduced to zero. “That’s what Renewal has achieved,” Rees said, “and that is nothing short of amazing.”

"Rees contacted Duke University to see if researchers there could investigate whether Renewal’s model could be replicated in Christian communities.

"Last year, two Duke professors, David Toole and Kim Krawiec, put together an interdisciplinary team of faculty and students, including lawyers, physicians, sociologists and theologians, to examine new methods of increasing living kidney donation...."Renewal leads donors and recipients through every stage of the transplant process. It is particularly important for kidney donors, who receive very little financial support from insurance companies and the state. Renewal covers lost wages, transportation and any necessary hotel costs. It also offers domestic support such as house cleaning, laundry services and catering. Reiner said that the average cost of a transplant, including the group’s administrative overhead, is about $20,000...."The United Network for Organ Sharing, which tracks donations nationally, counts a kidney donation as “altruistic” only if the donor does not specify to whom the kidney is given. Last year it tracked 180 such altruistic donations.

"Because Renewal’s donors choose the recipient of their kidney — even though they have no personal relationship with them — UNOS categorizes them in a larger pool of 1,273 living donors who directed their kidney to a “non-relative.”

"Based on this method, Renewal’s donors account for about 2% or 3% of living donations to non-family members.

"But Duke University’s Toole says that it is unfair to compare Renewal’s donors to most other donors in this larger pool because most of those donors know the recipient of their kidney. Renewal’s donors give to strangers. “What makes the model so interesting,” Toole said, is that “it’s some in-between space” between directed donations and altruistic donations."**************